Beriberi is a condition caused by severe prolonged deficiency of vitamin B1 (also known as thiamine). Beriberi refers to a constellation of heart, gastrointestinal, and nervous system problems from thiamine deficiency.
Thiamine is found in a variety of foods, particularly whole grains, legumes, and pork. Thiamine serves as a coenzyme in the chemical pathway responsible for the metabolism of carbohydrates. Thiamine deficiency interferes with the metabolism of glucose and the production of energy.
Four major types of beriberi exist: wet beriberi, which affects primarily the cardiovascular system; dry beriberi, which affects primarily the nervous system; shoshin, which is a rapidly evolving and frequently fatal form of cardiovascular beriberi; and infantile beriberi, which tends to strike babies between the ages of one and four months who are breastfed by mothers who are severely thiamine deficient.
Because so many foods in the United States and other western countries are vitamin enriched, beriberi is extremely rare. In developed countries, beriberi is primarily a complication of malnutrition secondary to alcoholism or gastrointestinal disorders. Because alcoholism affects more males than females, rates of beriberi in developed countries are higher among males. The syndrome of symptoms caused by thiamine deficiency in alcoholism is called Wernicke-Korsakoff syndrome.
In developing countries, where diets are more limited, beriberi is endemic. In some areas of Asia, people subsist on polished rice, in which the outer, more nutritious husk is removed. The rates of beriberi in these areas are quite high. In certain parts of Indonesia, the prevalence of beriberi among low-income families is as high as 66%. The majority of patients with beriberi are infants (ages 1–4 months) and adults.
Rosalyn Carson-DeWitt MD, The Gale Group Inc., Gale, Detroit,